The Impact of COVID-19 on Multidisciplinary Care Delivery to Children with Cerebral Palsy and Other Neuromuscular Complex Chronic Conditions

The COVID-19 pandemic has caused unprecedented challenges in the care of children with cerebral palsy (CP) and other neuromuscular complex chronic conditions (NCCCs). The purpose of this study is to explore the direct impact of the COVID-19 pandemic on healthcare delivery. From May to August 2020, m...

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Main Authors: Hillary Brenda Nguyen, Neha Mulpuri, Danielle Cook, Michael Greenberg, M. Wade Shrader, Ryan Sanborn, Kishore Mulpuri, Benjamin J. Shore
Format: Article
Language:English
Published: MDPI AG 2023-09-01
Series:Children
Subjects:
Online Access:https://www.mdpi.com/2227-9067/10/9/1555
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author Hillary Brenda Nguyen
Neha Mulpuri
Danielle Cook
Michael Greenberg
M. Wade Shrader
Ryan Sanborn
Kishore Mulpuri
Benjamin J. Shore
author_facet Hillary Brenda Nguyen
Neha Mulpuri
Danielle Cook
Michael Greenberg
M. Wade Shrader
Ryan Sanborn
Kishore Mulpuri
Benjamin J. Shore
author_sort Hillary Brenda Nguyen
collection DOAJ
description The COVID-19 pandemic has caused unprecedented challenges in the care of children with cerebral palsy (CP) and other neuromuscular complex chronic conditions (NCCCs). The purpose of this study is to explore the direct impact of the COVID-19 pandemic on healthcare delivery. From May to August 2020, medical professionals caring for CP and NCCC patients across multiple countries and disciplines completed a self-administered cross-sectional survey comparing practices before and during the COVID-19 pandemic. Of the 79 healthcare workers from eight countries who participated—predominantly pediatric orthopedic surgeons (32%), pediatricians (30%), and pediatric physiatrists (23%)—most of them felt that caring for NCCC patients during the pandemic presented unique difficulties, and they reported a significant decrease in the in-person NCCC clinic volume (<i>p</i> < 0.001), multidisciplinary appointments (<i>p</i> < 0.001), surgical cases (<i>p</i> = 0.008), and botulinum toxin/phenol injections. Most providers affirmed that institutional guidelines for perioperative emergent/urgent and elective procedures, workplace settings, and technology were modified to accommodate the ongoing public health crisis. The usage of telemedicine significantly increased for NCCC patient visits (<i>p</i> < 0.001). During the COVID-19 pandemic, many children with NCCCs lost access to routine, multidisciplinary care. Telemedicine became an integral part of communication and management. In the setting of the COVID-19 pandemic and with the threat of future healthcare disruptions, these data lay the foundation for trending the evolution of healthcare delivery and accelerating best practice guidelines for children with CP and NCCCs.
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spelling doaj.art-92e47dd918d04ed6bfc5932cacfe022d2023-11-19T10:04:09ZengMDPI AGChildren2227-90672023-09-01109155510.3390/children10091555The Impact of COVID-19 on Multidisciplinary Care Delivery to Children with Cerebral Palsy and Other Neuromuscular Complex Chronic ConditionsHillary Brenda Nguyen0Neha Mulpuri1Danielle Cook2Michael Greenberg3M. Wade Shrader4Ryan Sanborn5Kishore Mulpuri6Benjamin J. Shore7Harvard Medical School, Boston, MA 02115, USADepartment of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USABoston Children’s Hospital, Department of Orthopedic Surgery, Boston, MA 02115, USABoston Children’s Hospital, Department of Orthopedic Surgery, Boston, MA 02115, USADepartment of Orthopedic Surgery, Alfred I. Dupont Institute, Wilmington, DE 19803, USABoston Children’s Hospital, Department of Orthopedic Surgery, Boston, MA 02115, USADepartment of Orthopaedics, BC Children’s Hospital, University of British Columbia, Vancouver, BC V6H3NA, CanadaHarvard Medical School, Boston, MA 02115, USAThe COVID-19 pandemic has caused unprecedented challenges in the care of children with cerebral palsy (CP) and other neuromuscular complex chronic conditions (NCCCs). The purpose of this study is to explore the direct impact of the COVID-19 pandemic on healthcare delivery. From May to August 2020, medical professionals caring for CP and NCCC patients across multiple countries and disciplines completed a self-administered cross-sectional survey comparing practices before and during the COVID-19 pandemic. Of the 79 healthcare workers from eight countries who participated—predominantly pediatric orthopedic surgeons (32%), pediatricians (30%), and pediatric physiatrists (23%)—most of them felt that caring for NCCC patients during the pandemic presented unique difficulties, and they reported a significant decrease in the in-person NCCC clinic volume (<i>p</i> < 0.001), multidisciplinary appointments (<i>p</i> < 0.001), surgical cases (<i>p</i> = 0.008), and botulinum toxin/phenol injections. Most providers affirmed that institutional guidelines for perioperative emergent/urgent and elective procedures, workplace settings, and technology were modified to accommodate the ongoing public health crisis. The usage of telemedicine significantly increased for NCCC patient visits (<i>p</i> < 0.001). During the COVID-19 pandemic, many children with NCCCs lost access to routine, multidisciplinary care. Telemedicine became an integral part of communication and management. In the setting of the COVID-19 pandemic and with the threat of future healthcare disruptions, these data lay the foundation for trending the evolution of healthcare delivery and accelerating best practice guidelines for children with CP and NCCCs.https://www.mdpi.com/2227-9067/10/9/1555COVID-19cerebral palsyneuromuscular conditionspediatricsorthopedics
spellingShingle Hillary Brenda Nguyen
Neha Mulpuri
Danielle Cook
Michael Greenberg
M. Wade Shrader
Ryan Sanborn
Kishore Mulpuri
Benjamin J. Shore
The Impact of COVID-19 on Multidisciplinary Care Delivery to Children with Cerebral Palsy and Other Neuromuscular Complex Chronic Conditions
Children
COVID-19
cerebral palsy
neuromuscular conditions
pediatrics
orthopedics
title The Impact of COVID-19 on Multidisciplinary Care Delivery to Children with Cerebral Palsy and Other Neuromuscular Complex Chronic Conditions
title_full The Impact of COVID-19 on Multidisciplinary Care Delivery to Children with Cerebral Palsy and Other Neuromuscular Complex Chronic Conditions
title_fullStr The Impact of COVID-19 on Multidisciplinary Care Delivery to Children with Cerebral Palsy and Other Neuromuscular Complex Chronic Conditions
title_full_unstemmed The Impact of COVID-19 on Multidisciplinary Care Delivery to Children with Cerebral Palsy and Other Neuromuscular Complex Chronic Conditions
title_short The Impact of COVID-19 on Multidisciplinary Care Delivery to Children with Cerebral Palsy and Other Neuromuscular Complex Chronic Conditions
title_sort impact of covid 19 on multidisciplinary care delivery to children with cerebral palsy and other neuromuscular complex chronic conditions
topic COVID-19
cerebral palsy
neuromuscular conditions
pediatrics
orthopedics
url https://www.mdpi.com/2227-9067/10/9/1555
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